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Early Hyperglycemia And Brain MRI Findings In Very Preterm Infants
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.. (Forskargrupp; Perinatal, neonatal och barnkardiologisk forskning)
Univ Lisbon, Fac Sci, Inst Biophys & Biomed Engn, Lisbon, Portugal..
Univ Lisbon, Fac Sci, Inst Biophys & Biomed Engn, Lisbon, Portugal..
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no SI 469, p. 16-16Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objective: A previous study in extremely preterm infants demonstrated an association between hyperglycemia >8.3 mmol/l (150 mg/dl) on the first day of life and white matter reduction. The objectives of the present study were to further investigate possible associations between hyperglycemia and abnormal brain development and to evaluate the effect of hyperglycemia on neurodevelopment.

Method: Retrospective study of cerebral MRIs performed at term equivalent age in 75 very preterm infants (GA 22–31 weeks) born 2011–2015. The highest glucose values for each day, and the number of days with glucose >8.3 mmol/l during the first week of life were analyzed in relation to clinical data and MRI (1.5 T). The MRI evaluation included: visual scoring of gray and white matter abnormalities; measurement of apparent diffusion coefficient (ADC) in periventricular white matter, basal ganglia and pons, and a newly developed method for semi-automatic segmentation of brain volumes. MRI data were analyzed without knowledge of clinical data. No infant had IVH grade 3–4. No infant received insulin. Follow up at 2.5 years of corrected age is ongoing; data including Bayley Scales of Infant Development (BSID-III) was available in 45 infants.

Results: Clinical data are shown in the table. Significant (p < 0.05) univariate correlations were found between GA, BW, days on mechanical ventilation, highest blood glucose levels on days 2–5 and number of days with glucose >8.3 mmol/l, PVL and white matter volume. Days with glucose >8.3 mmol/l correlated independently with reduced white matter volume (p = 0.045), but not GA and days on mechanical ventilation. When BW was included in the analysis, days with glucose >8.3 mmol/l reached borderline significance (p = 0.068), but no other factor reached significance. For PVL, days of mechanical ventilation was the only independently associated factor (p = 0.012). In the 45 infants with follow up, only days with glucose >8.3 mmol/l was independently associated with a lower motor index on BSID-III.

Conclusion: Prolonged duration of high blood glucose >8.3 mmol/l during the first week of life in very preterm infants is associated with reduced white matter volume and may also be associated with poorer motor performance at 2.5 years.

Place, publisher, year, edition, pages
2017. Vol. 106, no SI 469, p. 16-16
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-333331DOI: 10.1111/apa.13877/fullISI: 000405213500022OAI: oai:DiVA.org:uu-333331DiVA, id: diva2:1157109
Available from: 2017-11-15 Created: 2017-11-15 Last updated: 2017-11-15Bibliographically approved

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Naseh, NimaGonzalez, Karla Elizabeth TamezKaul, Ylva FredrikssonJohansson, MartinÅgren, JohanCanto Moreira, NunoHellström-Westas, Lena

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